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American Association for Homecare Supports President Obama in His Commitment to Stop Waste, Fraud and Abuse in Medicare
Date:2/26/2009

egislative action plan stops fraud and abuse where they start in the Medicare system. The plan calls for increased penalties for fraud, more site inspections, more rigorous quality standards and real-time claims analysis, among other steps.

In the Medicare Anti-Fraud Legislative Plan, the American Association for Homecare proposes the following 13 specific recommendations to stop fraud and abuse in the home medical sector:

1. Mandate Site Inspections for All New Home Medical Equipment Providers

A July 2008 GAO report underscored the need for CMS to ensure that its contractors are conducting effective site inspections for all new applicants for a Medicare supplier number.

2. Require Site Inspections for All HME Provider Renewals

All renewal applications should require an in-person visit by the National Supplier Clearinghouse (NSC), the contractor that CMS uses to ensure integrity in the Medicare program.

3. Improve Validation of New Homecare Providers

Additional validation of new providers should be included in a comprehensive and effective application process for obtaining a Medicare supplier number.

4. Require Two Additional Random, Unannounced Site Visits for All New Providers

Two unannounced site visits should be conducted by NSC during the first year of operation for new HME providers.

5. Require a Six-Month Trial Period for New Providers

The NSC should issue a provisional, non-permanent supplier number to new suppliers for a six-month trial period. After six months of demonstrated compliance, the provider would receive a "regular" supplier number.

6. Establish an Anti-Fraud Office at Medicare

CMS should establish an office with the sole mandate of coordinating detection and deterrence of fraud and improper payments across the Medicare and Medicaid programs.

7. Ensure Proper Federal Fun
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SOURCE American Association for Homecare
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